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Union Public Service Commission

Application For The Post of Assistant Provident Fund Commissioner

Registration id : 6btppus4
Advertisement No.

Vacancy No.

Application No.

Registration Details :

Mother's Name : Gender : Date Of Birth : Place Of Birth : Name of the State you were born : Nationality : Minority Community Marital Status : Community : Community Subcaste/State :

URMILA DEVI Male 05-07-1982 BARAUNI Bihar India Citizen of India Nil Single SC Chamar, Mochi, Chamar-Rabidas, Chamar-Ravidas, Chamar-Rohidas, Charmarkar / (Bihar) COOKING ( Five July Nineteen Eighty Two )

E-mail Address : Hobby :

Contact Details :
VILL NAZIRPUR PS UJIYARPUR PO CHANDCHAUR SAMASTIPUR SAMASTIPUR Bihar India Pin :848114 Permanent Address : Office(Landline) : Residence(LandLine): Mobile : 9931640680 BH 26 BIRLADHAM RLY STN KOSAMBA BHARUCH BHARUCH Gujarat India Pin :394120 Mailing Address: Office(Landline) : Residence(LandLine) : Mobile : 9601002303

Physically Challenged : Physically Challenged (PH) : NO

Age Relaxation : Age Relaxation : NO



Union Public Service Commission

Fee Exemption : Fee Exemption : SC

Matriculation Qualification :
Exam passed Matriculation or Equivalent 12th Board Central Board of Secondary Education, Delhi Central Board of Secondary Education, Delhi Year of Result 1997 1999 Result Type Percentage Percentage Score 50 51

Educational Qualification(s) :
Date of Notification of Result / Issue Of Final Marksheet 20-122006

Qualification Type



Qualification Level

Specialization / Mandatory Subject

University / College


Division / Class

Result Type / Result Score

Date of Degree



Chemical Engineering


chemical engineering

Malviya National Institute of Technology,Jaipur / MNIT JAIPUR

Jul2002 Dec2006


Percentage / 59


Total Experience: 0 Years 0 Months 0 Days

Recruitment Test Centre : First Preference : Second Preference : Ahmedabad Mumbai

DQ Declaration : DQ Declaration YES

Payment Details
Fee Exempted

I hereby declare that all the statements made in the application are true and complete to the best of my knowledge and belief.I understand that action can be taken against me by the Commission if Iam declared by them to be guilty of any type for misconduct mentioned herein. I have informed my Head Office/Deptt. in writing that I am applying for this selection.
Date: 03-05-2012

Signature of the candidate

Application No. 11901343459



Union Public Service Commission


Candidates are warned that they should not furnish any particulars that are false or suppress any material information in filling up the application form. Candidates are also warned that they should in no case correct or alter or otherwise tampered with any entry in a document or its attested/certified copy submitted by them nor should they submit a tampered/fabricated document. If there is any inaccuracy or any discrepancy between two or more such documents or their attested/certified copies, an explanation regarding this discrepancy should be submitted. A candidate who is or has been declared by the Commission to be guilty of: Obtaining support of his/her candidature by any means, or Impersonating, or procuring impersonation by any person , or submitting fabricated documents or documents which have been tampered with, or Making statements which are incorrect or false or suppressing material information, or Resorting to any other irregular or improper means in connection with his/her candidature for the selection, or Using unfair means during the test, or Writing irrelevant matter including obscene language or pornographic matter, in the script(s) , or Misbehaving in any other manner in the examination hall, or Harassing or doing bodily harm to the staff employed by the Commission for the conduct of their test, or Bringing mobile phone/Communication device in the examination Hall/Interview room. Attempting to commit or, as the case may be, abetting the Commission of all or any of the acts specified in the foregoing clauses may, in addition to rendering himself/herself liable to criminal persecution, be liable: (a) to be disqualified by the Commission from selection for which he/she is a candidate, and/or (b) to be debarred either permanently or for a specified period:by the Commission from any examination or selection held by them by the Central Government from any employment under them, and (c) if he/she is already in service under Government to disciplinary action under the appropriate rules.



Union Public Service Commission

Application No.: 11901343459

Registration Id: 6btppus4

List of Documents/ Certificates enclosed with the Printout of Online Recruitment Application (Note: Only Documents/ Certificates specified in the Advertisement are to be enclosed)

Sl. No.

Name of specified Documents/ Certificate

Name: Signature: